Should I go on the pill? 

By Quilla Watt, Integrative Naturopath

Someone recently asked me if I thought they should go on the pill, but I couldn’t give a simple “yes” or “no” answer. Figuring out what is the best form of contraception is very individual – you have to work out what is going to work for you. 

For many women, the pill is a convenient and reliable form of contraception. The pill supplies synthetic hormones that suppress our own hormones, and prevent ovulation. Women can take either the combined oral contraceptive pill (contains an oestrogen and progestogen combination), or progestogen-only pill. A regular course of the pill usually has a series of placebo pills that contain no active hormones, and this is when you get your “period”. I say “period” because while it looks like a regular menstrual period, it is not- the synthetic hormones have built up your uterine lining, and stopping them makes it shed, however no ovulation takes place during the cycle.

 

Why take the pill?

Some women want to take the pill because it is more convenient that using condoms. Firstly, let’s get something straight – the pill is a form of contraception. It in no way protects you from STIs. I have to admit I’m a little surprised by the number of young women that think because they take the pill they don’t need to worry about anything else. Just because you are on the pill, does not mean you should throw out the condoms.

Some women want to take the pill because it is more effective that using condoms. The combination pill is more than 99% effective at preventing pregnancy. Condoms are 98% effective. So if you are using condoms correctly, your chance of getting pregnant is 2 in 100, as opposed to less than 1 in 100 with the pill. For some women, this feels like a worthwhile difference, but other women are not happy to put up with potential side effects for such a small difference.

Then there are women who are thinking of going on the pill for other reasons – to manage painful periods, heavy periods, absent or irregular periods, poly-cystic ovarian syndrome (PCOS), or endometriosis. For these women, the pill will mask the problem without fixing the cause. There is so much more we can do to address the underlying cause of the condition than just taking synthetic hormones.

 

Known side effects of the pill

Spotting: 

If you start taking the pill, it is common to get some light bleeding (spotting) during your cycle in the first 3 months. This usually settles by the third cycle, but for 10% of women, spotting can continue.

Headaches:

Women can experience headaches when first starting the pill, and if you do, its important to have a chat with your GP and let them know.

Weight gain: 

Women often complain of weight gain when they start the pill. However, studies haven’t found this to be the case. It looks like the pill causes fluid retention, especially in the breast, hips and thighs, which can look like weight gain. There are also questions around whether the pill causes insulin resistance, however I haven’t seen enough research to be able to confirm this as yet.

Breast tenderness: 

You can experience breast swelling and tenderness when starting the pill. This may just be due to retaining fluid in the breast, however if you notice a lump or severe breast pain, you need to chat to your GP about this.

Mood changes: 

While the research isn’t conclusive that the pill can cause depression, there are a few researchers in the field that are quite convinced of the mood changes that can occur with the pill. Certainly in clinic, we see women who experience low mood, irritability, or become more emotional when going on the pill. If you have a history of depression, you should chat with your GP about this before going on the pill

Decreased libido: 

The hormones in the pill can change your body’s testosterone and DHEA levels, and lower your libido. You may find you have less interest in sex, and fewer sexual thoughts. Some women do not realise that this can be a side effect, and blame themselves for not feeling interested. This can have a profound effect on your mood and your relationship.

Cardiovascular side effects:

The newer combination pills with the form of synthetic progesterone called drospirenone may have a higher risk of blood clots including deep vein thrombosis and pulmonary embolism.  All combination pills come with a slightly increased risk of cardiovascular events such as heart attack, stroke and blood clots. If you have a history of any of these, the combination pill is not for you. Its also not recommended in women who are obese, have a family history of heart disease, or are over 35 and smoke.

Cancer:

The pill appears to increases your risk of some cancers (cervical and liver), and decrease your risk of others (ovarian and endometrial cancer). The evidence around breast cancer is not clear – earlier studies showed a link between pill use and breast cancer, while more recent studies have not.

 

Other possible consequences of the pill

In clinic, we can see hair loss in women on the pill. We can also see acne flare up once the pill is stopped. Some women can take time to get their periods back after stopping the pill, which is known as post-pill amenorrhea. It can take your body a bit of time to start making its own hormones again, but your period usually returns in 3 months. If it doesn’t, it’s a good idea to speak to your naturopath. There’s plenty we can do the help get your periods back on track.

If you started taking the pill for painful periods, heavy periods, or for endometriosis, it’s important to work on this before you come off the pill, to prevent your symptoms returning.

As a parting comment, its good to remember that as far as contraceptives, there are far more options than just the pill or the condom. The latest non-hormonal IUDs are far safer than their earlier versions, and are worth looking in to. Like I said at the start- it’s about working out what works for you. 

 

Lyme Disease Co-infections

Ticks can carry more than just Lyme disease. When people are infected with Lyme, they can also be infected with other nasty organisms from the same tick bite. We call these guys Lyme co-infections. Diagnosing Lyme disease should include checking for co-infections. Lyme co-infections further complicate an already complex condition. Each co-infection can alter the symptom picture, and can make primary Lyme symptoms much worse. Treatment programs have to be tailored to also target the co-infections, and recovery can take much longer. But without treating the co-infections, the patient cannot regain full health. Common co-infections include Babesia, Bartonella, Rickettsia, and Erlichia.

Babesia

Babesia is a parasite similar to the one that causes malaria. As in malaria, Babesia parasites infect the red blood cells and cause similar symptoms. Babesia infection can often have mild, nonspecific symptoms. It can also be severe and life threatening, especially in the elderly and in people who are immunocompromised. 

Acute infection involves fever, chills and haemolytic anaemia. Less severe cases may experience a more gradual onset of headaches, fatigue, loss of appetite, muscle and joint pain, high fever and shaking chills, nausea, and vomiting.

Lyme patients with Babesia co-infection also often experience blurry vision, ringing in the ears, dizziness and lightheadedness, shortness of breath and a feeling of pressure on the chest, night sweats, nausea, and sometimes Bell’s palsy. There is also a cycle of flare-ups every 4-6 days. Lyme patients who fail to respond to treatment can often have an untreated Babesia co-infection.

Bartonella

Bartonella are aerobic bacteria that like to live inside cells. As with Babesia, Bartonella infection can range from mild to severe. With Bartonella the onset of illness is slow. Signs and symptoms include swollen lymph glands, fever, fatigue, headaches, an unusual streaked rash, enlarged spleen, raised liver enzymes, and aches and pains in joints, muscles and bones.

Lyme patients with Bartonella co-infection can also experience light sensitivity, neurological symptoms including tremors and muscle twitching, racing heart, headaches, anxiety, agitation, new stretch marks, and tender nodules under the skin, usually on the shin, outer thigh and back of the arm. There can be rapid improvement following treatment, but the symptoms can return if treatment is stopped too soon.

Rickettsia

Rickettsia are a group or organisms that lie somewhere between bacteria and viruses. Rickettsial diseases range from mild illnesses to severe life-threatening infections. Common symptoms include headache, fever, chills, and aching muscles. Depending on the type of Rickettsia, there may also be a rash, cough, chest pain, runny nose, sore throat, nausea and vomiting, and abdominal pain.

Erlichia

Erlichia comes with a rapid onset of symptoms. These include muscle pain (but not necessarily joint pain), headaches, and neurological symptoms such as shooting pains and seizures. Tests may show a low white blood cell count and raised liver enzymes. We also usually see fast improvement with treatment.

Testing for co-infections

Testing for Rickettsia can be done by your GP and is covered by Medicare. Unfortunately, Australia is behind on the testing for Babesia, Bartonella, and Erlichia. For the most reliable co-infections testing we use IGeneX, a specialist Lyme lab in the US.

Lyme disease - Integrative Treatment Approach Part Two

In part one we identified what Lyme disease, or Lyme Borreliosis, is and how it is transmitted. Now we take a look at testing and further treatment.

 

Testing for Lyme disease

Testing for Lyme disease is not straightforward. Lyme disease, the bacteria called Borrelia, can live in tissues, organs, the nervous system, and in collagen and joints. So may not come up in blood tests, especially in chronic cases. Rather than use blood tests to detect the bacteria, the tests are used to check the body’s immune response to it.

 

The tests currently used to diagnose Lyme are very poor at detecting Borrelia, and results may come back falsely negative. This leaves a significant number of individuals with Lyme disease undiagnosed and untreated.

Studies have indicated that PCR (polymerase chain reaction) is more accurate than culture and serologic testing in early Lyme disease. There are only a few laboratories in the world that offer more comprehensive Lyme testing, and only one in Australia.

 

What about CD57+?

If you have read through any forums on Lyme disease chances are you have come across the term CD57+. This is a test that some practitioners are using in Lyme disease. Lymphocytes, a class of white blood cells, have different markers
on them. One of these markers is the CD57 marker. Cells with the marker are said to be CD57+. The CD57+ test measures how many lymphocytes have this marker on them.

 

One study (and two case reports) from the early 2000’s reported that patients with chronic Lyme disease have low levels of CD57+ cells. They found that when patients responded to treatment, these levels went up; and in patients who did not respond to treatment, these levels stayed low. However, another group of researchers found that there was no correlation between CD57+ cells and Lyme disease.

 

So there are only really two studies that have looked at CD57+ cells in Lyme, and one found that it was a good marker for Lyme, and one found that it was not. Given the research we have to go on, we really cant say whether it is reliable for Lyme.

 

The complexities of treating Lyme disease

Treatment of Lyme disease can be a long and difficult journey. At The Health Lodge, our treatment plan for patients with Lyme disease involves three main phases.

 

Phase 1: Detox

Detoxification is the first and hardest part of the treatment process. Borrelia, like several other bacteria, produces neurotoxins. These compounds can cause many of the virus-like symptoms common in Lyme disease, and also potentially interfere with hormone action by blocking hormone receptors.  It has been said that the longer one is ill with Lyme, the more neurotoxin is present in the body.  It probably is stored in fatty tissues, and once present, persists for a very long time.

 

Phase 2: Pathogen clearing

Lyme disease is not your average bacterial infection. Ticks often carry other organisms, including Babesia, Rickettsia, Ehrlichia, and Bartonella. These can be transmitted to humans at the same time as the Borrelia bacteria, causing co-infection. It is incredibly important to test and treat these co-infections as well. Animal and human studies show that these co-infections can cause more severe and treatment-resistant Lyme disease.

 

Phase 3: Breaking down biofilms

Borrelia is also capable of creating a biofilm. A biofilm is a slippery, glue-like coating that some bacteria create to act as a protective shield. The plaque on your teeth is a type of biofilm produced by Treponema denticola, which causes gum disease. To create the biofilm, the bacteria clump together and build a complex matrix around themselves. They can do this on a range of surfaces including our soft tissues. Other organisms, including the co-infections common in Lyme disease, can live inside the biofilm. The biofilm protects the bacteria from attacks from the immune system and antibiotics.  The Borrelia biofilm is one of the reasons Lyme disease and its co-infections are so difficult to treat.

 Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of Lyme disease. The multidisciplinary team may include general practitioners, psychologists, nutritionists, naturopaths, osteopaths, and acupuncturists. This comprehensive and holistic approach is designed to support the patient’s physical, mental, and emotional well being.

For enquiries call The Health Lodge on 02 6685 6445

 

Your smartphone could be good for your mental health

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Joanna Rodriguez, University of Surrey and Nadine Page, University of Surrey

When it comes to mental health, technologies such as smartphones and social media networks are almost always discussed in terms of the dangers they pose. Alongside concerns expressed in the media, some experts believe that technology has a role in the rising rates of mental health problems. However, there is also evidence to suggest your smartphone could actually be good for your mental health.

The brain is a sensitive organ that reacts and adapts to stimulation. Researchers have looked into smartphone usage and the effects on the day-to-day plasticity of the human brain. They found that the finger movements used to control smartphones are enough to alter brain activity.

This ability of technology to change our brains has led to questions over whether screen-based activity is related to rising incidence of such conditions as attention deficit hyperactivity disorder (ADHD) or an increased risk of depression and insomnia. Technology has also been blamed for cyber-bullying, isolation, communication issues and reduced self-esteem, all of which can potentially lead to mental ill health.

Positive potential

However, focusing only on the negative experiences of some people ignores technology’s potential as both a tool for treating mental health issues and for improving the quality of people’s lives and promoting emotional well-being. For example, there are programmes for depression and phobias, designed to help lift people’s moods, get them active and help them to overcome their difficulties. The programmes use guided self help-based cognitive behavioural principles and have proven to be very effective.

Computer games have been used to provide therapy for adolescents. Because computer games are fun and can be used anonymously, they offer an alternative to traditional therapy. For example, a fantasy-themed role-playing game called SPARX has been found to be as effective as face-to-face therapy in clinical trials.

Researcher David Haniff has created apps aimed at lifting the mood of people suffering from depression by showing them pleasing pictures, video and audio, for example of their families. He has also developed a computer game that helps a person examine the triggers of their depression. Meanwhile, smartphone apps that play subliminal relaxing music in order to distract from the noise and worries of everyday living have been proven to be beneficial in reducing stress and anxiety.

Doctor on call Shutterstock

Technology can also provide greater access to mental health professionals through email, online chats or video calls. This enables individuals to work remotely and at their own pace, which can be particularly useful for those who are unable to regularly meet with a healthcare professional. Such an experience can be both empowering and enabling, encouraging the individual to take responsibility for their own mental well-being.

This kind of “telemedicine” has already found a role in child and adolescent mental health services in the form of online chats in family therapy, that can help to ensure each person has a chance to have their turn in the session. From our own practice experience, we have found young people who struggle to communicate during face-to-face sessions can be encouraged to text their therapist as an alternative way of expressing themselves, without the pressure of sitting opposite someone and making eye contact.

Conditions such as social anxiety can stop people seeking treatment in the first place. The use of telemedicine in this instance means people can begin combating their illness from the safety of their own home. It is also a good way to remind people about their appointments, thus improving attendance and reducing drop-out rates.

New routes to treatment

The internet in general can provide a gateway to asking for help, particularly for those who feel that stigma is attached to mental illness. Accessing information and watching videos about people with mental health issues, including high-profile personalities, helps to normalise conditions that are not otherwise talked about.

People can use technology to self-educate and improve access to low-intensity mental health services by providing chat rooms, blogs and information about mental health conditions. This can help to combat long waiting times by providing support earlier and improving the effectiveness of treatment.

More generally, access to the internet and use of media devices can also be a lifeline to the outside world. They allow people to connect in ways that were not previously possible, encouraging communication. With improved social networks, people may be less likely to need professional help, thus reducing the burden on over stretched services.

Research into the potential dangers of technology and its affect on the brain is important for understanding the causes of modern mental health issues. But technology also creates an opportunity for innovative ways to promote engagement and well-being for those with mental health problems. Let’s embrace that.

The Conversation

Joanna Rodriguez is Senior tutor at University of Surrey and Nadine Page is Teaching Fellow (Integrated Care) at University of Surrey

This article was originally published on The Conversation. Read the original article.